Substance Abuse: Terms, Definitions, and Theories, Quizzes of Banking Law and Practice

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TERM 1 Stats on substance abuse DEFINITION 1 US has one of highest SA rates Early onset assoc'd with SA in adulthood ETOH M>F High Risk: <HS edu, family hx, never married, low socioecon Rates highest among Native americans & whites Tobacco use leading preventable cause of death 50% crimes=using substances Denial, rationalization, minimalization, projection= norm TERM 2 Intoxication DEFINITION 2 Syndrome in which significant maladaptive psychological, physiological and behavioral changes occur during and shortly after ingestion of a substance TERM 3 Abuse DEFINITION 3 Continued use of a substance, despite the occurrence of substance-related problems TERM 4 Dependence DEFINITION 4 Physiological and/or psychological reliance on a substance (addiction) TERM 5 Withdrawal DEFINITION 5 Physiological reaction that occur when the substance use is reduced or stopped; reflects biological (physical) adaptation of the body to the substance TERM 6 Tolerance DEFINITION 6 With continued use of a substance, more is needed to produce the same effect TERM 7 Criteria for substance abuse DEFINITION 7 A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by: Failure to fulfill major role obligations, such as work, school, or home Recurrent substance use in hazardous situations, such as driving a car or operating machinery Recurrent substance-related legal problems Other significant problems that can be related to recurrent substance use, such as impairment in social or interpersonal relationships TERM 8 Criteria for substance dependence DEFINITION 8 A maladaptive pattern of substance use as manifested by >= 3 of the following: Tolerance: body adapts to substance, need more to get desired effect Withdrawal Syndrome Substance is used in larger amounts or for a longer time period than intended (marker of loss of control) Inability to stop when wanting to do so Use of substance assoc'd w/ significant role function problems preoccupation with obtaining the substance/time to obtain TERM 9 Biologic theory on addiction DEFINITION 9 Family hx, adoption and twin studies all suggest that genetics may play a substantial role in at least some forms of addiction Minor (A1) allele of the DRD2 dopamine recptor gene has been linked to severe alcoholism and polysubstance dependence Dopamine reward pathway: drugs of addiction are identifiable by their ability to stimulate the dopamine secretion in this pathway TERM 10 The mesolimbic theory and addiction DEFINITION 10 Mesolimbic pathway uses reward to promote life sustaining and life fulfilling behaviors (eating, drinking, sex, nurturing) Addiction occurs by dysregulation of this natural function Addiction hijacks and reprograms this reward system Reward system works by increasing levels of dopamine in the dorsal striatum TERM 21 Alcohol withdrawal syndrome DEFINITION 21 Occurs when there is a cessation of (or reduction in) alcohol use that has been heavy and prolonged. Stages: 6-8 hours after drinking: Anxiety, hyperreflexia, hypertension, tachycardia, diaphoresis, hyperthermia, N/V insomnia 24 hours after last drink: auditory and visual hallucinations, anxiety, tremor autonomic hyperactivity, pt is lucid and oriented 7-48 hrs after last drink: grandmaul seizures 3-5 days after drink. Delerium, confusion, hallucinations, agitation, tachycardia and fever TERM 22 Tx of alcohol withdrawal DEFINITION 22 Goals are physio stability and prevention of injury Admin CIWA scale - Monitor VS and severity of ETOH withdrawal.Admin O2 PRN Admin fluid, multivit, folic acid and thiamine Admin long acting benzos (librium= drug of choice) Observe/report s/sx impeding seizures Monitor I/O and critical lab values Minimal stimulation env with low lights Seizures precautions PRN Arrange sitter if possible (prevent phys. restraints) TERM 23 Naltrexon DEFINITION 23 (Revia)Diminishes cravings for ETOH TERM 24 Antabuse DEFINITION 24 (Dislfiram) ETOH deterrent Does not reduce cravings Ingestion of ETOH with this drugs will cause unpleasant feelings Need to avoid anything with ETOH (mouth wash, after shave) TERM 25 Acamprosate DEFINITION 25 (Campral) Synthetic compound similar to GABA. Decreases cravings Helps with those that have emotional issues or are anxious TERM 26 Main Opiates DEFINITION 26 Heroin Morphine Demerol TERM 27 Characteristics of heroin intoxication DEFINITION 27 Constricted pupils Lethargy Nausea Respiratory depression Coma TERM 28 Heroin withdrawal DEFINITION 28 Very uncomfortable like a bad case of the flu, but usually not life threatening Stage 1: (6-12 hrs) anxiety, rhinorrhea, lacrimation Stage 2: (48-72 hours since last use): Restless, irritability, shaking, nausea, vomiting, muscle spasms, abdominal cramps, diaphoresis TERM 29 Treatment of Opiate withdrawl DEFINITION 29 Administer COWS Medications for detox maintenance: Narcan Methadone Clonidine Suboxone Buprenex TERM 30 Types of stimulants DEFINITION 30 Cocaine Amphetamines Crack TERM 31 Cocaine Intoxication DEFINITION 31 Tachycardia Pupillary dilation Elevated BP Perspiration and chills N/V Agitation CP and cardiac arrhythmias Seizures TERM 32 Cocaine withdrawal DEFINITION 32 Stage 1: (1-4 days): "Crash", agitation, high cocaine craving, anorexia, depression Stage 2: (4-10 weeks) High craving for cocaine, depression TERM 33 Treatment of cocaine withdrawal DEFINITION 33 Antidepressant Antihypertensive TERM 34 Common Hallucinogens DEFINITION 34 Ecstasy LSD PCP TERM 35 Hallucinogen intoxication DEFINITION 35 Distorted perceptions Illusions Paranoid Mystical Experiences Incoordination Pupillary dilation Tachycardia Sweating Panic Reactions TERM 46 Rehab and Recovery DEFINITION 46 Goals: Insight into disease Meaningful change in maladaptive behaviors Improved functioning, health and QOL TERM 47 Nursing Interventions in Rehab/Recovery DEFINITION 47 Assess readiness to change Assess clients motivation to change Encourage client to participate in treatment Work from a motivational approach Refer client and family to other resources as appropriate to an individualized plan of care 40-60% of patients will relapse TERM 48 Model of change steps DEFINITION 48 Precontemplation Contemplation Preparation Action Maintenance TERM 49 Pre-contemplation of change DEFINITION 49 Other people are aware of the problem or harm caused by the patient's drug use, but the patient does not No desire to change See more positives than negatives in drug use TERM 50 Contemplation of change DEFINITION 50 Patient recognizes the problem but isn't sure what to do about it TERM 51 Preparation of change DEFINITION 51 Patient is ready to accept suggestions and strategies Patient is convinced they need to change TERM 52 Action in change DEFINITION 52 Patient begins to change his or her pattern of drug use TERM 53 Maintenance of change DEFINITION 53 Patient comes to terms with losses associated with drug use Uses strategies that have been successful to maintain abstinence or controlled use TERM 54 Substance Use and the family DEFINITION 54 Family disease Codependency Enabling: actions to protect codependent person. Cover for them Self help groups Recovery